Background Assisted reproductive technology (ART) has positively impacted the field of human reproduction. Over the years, ART procedures have evolved to include several complex techniques, associated with various risks of errors and failure opportunities, especially in laboratories. IVF-associated errors, although rare, have significant implications. Patients may be psychologically affected, given the emotional attachment associated with IVF treatments. Most of these errors are associated with humans and/or systemic failure. Methods In this article, we used the Google Scholar database to search for related peer-reviewed original and review articles. Search keywords were “IVF laboratory”, “the embryologist”, “laboratory error”, “IVF laboratory errors”, “IVF error prevalence”, “risks of IVF error”, “consequences/ repercussion, IVF errors”, “risk assessment”, and “risk mitigation”. All studies were extensively evaluated. Findings There is a need for an effective approach toward improving existing risk management systems and, possibly, developing better risk management models that can eliminate these errors. Because laboratory resources (equipment and human expertise) are finite and are dependent on systemic policies, error mitigation must involve a multidimensional approach. This review includes several of these error-mitigating strategies as well as innovative technologies that may provide practical approaches to improve error surveillance, reporting, management, and potentially, eradication. Furthermore, errors in IVF laboratories threaten the integrity of the IVF processes and pose significant implications, which are often negative. Conclusion This review highlights those errors and the stages they occur during the IVF process. Recommendations Understanding the risks of errors in IVF laboratories can help embryologists develop better approaches to identify, evaluate the causes, and prevent errors in the laboratory. Essentially, the practice of effective risks assessment and management can help reinforce patients’ trust in the clinics and prevent repercussions such as litigations and many more. More laboratories can also begin reporting even minor errors to curb the scarce data in this subject.

Study Question: What are the Safe and Ethical practices for ART applicable in INDIA? What is Already Known: The Indian IVF industry is booming; with mushrooming of assisted reproductive technology (ART) clinics in the country, the need for regulation is immense. The ISAR has taken up this initiative to lead the way forward in establishing practice guidelines for the safe and ethical use of ARTs in our country. These guidelines discuss the points to consider before the starting of an IVF unit, to the designing of the laboratory, the staffing pattern and experience recommendations, laboratory safety guidelines, documentation and patient traceability, gamete traceability, handling biological material, the consumables and media, and different consents and checklists and also propose key performance indicators for the Indian scenario. Study Design, Size, Duration: This is the report of a 2-day consensus meeting where two moderators were assigned to a group of experts to collate information on safe and ethical ivf practices in INDIA. This meeting utilised surveys, available scientific evidence and personal laboratory experience into various presentations by experts on pre-decided specific topics. Participants/Materials, Setting, Methods: Expert professionals from ISAR representing clinical and embryology fields. Main Results and the Role of Chance: The report is divided in various components including the regulations, the various requirements for an ART center, qualifications and trainings, recommendations on good practices and quality management: the report and recommendations of the expert panel reflect the discussion on each of the topics and try to lay down good practice points for labs to follow. Limitations, Reasons for Caution: The recommendations are solely based on expert opinion. Future availability of data may warrant an update of the same. Wider Implications of the Findings: These guidelines can help labs across the country to standardise their ART services and improve clinical outcomes. Study Funding/Competing Interest(S): The consensus meeting and writing of the paper was supported by funds from CooperSurgical India.

Study Question: What are the good practice guidelines for Pre implantation genetic testing applicable in INDIA? What is Already Known: Pre-Implantation Genetic Testing (PGT) is not new in India. It is used to identify euploid embryos for transfer, thus enabling couples to achieve a healthy pregnancy. There has been a lot of controversy surrounding PGT in the international forums; most of these debates have failed to reach a consensus on whether PGT should be offered or its concerns be validated more. Study Design, Size, Duration: This is the report of a 2-day consensus meeting where two moderators were assigned to a group of experts to collate information on Pre implantation genetic testing and embryo biopsy practices in INDIA. This meeting utilised surveys, available scientific evidence and personal laboratory experience into various presentations by experts on pre-decided specific topics. Participants/Materials, Setting, Methods: Expert professionals from ISAR representing clinical, embryological and genetic fields. Main Results and the Role of Chance: The report is divided into various components defining the terminologies, the various requirements, qualifications, recommendations on PGT -A,M,SR, and quality management: the report and recommendations of the expert panel reflect the discussion on each of the topics and try to lay down good practice points for labs to follow. Limitations, Reasons for Caution: The recommendations are solely based on expert opinion. Future availability of data may warrant an update of the same. Wider Implications of the Findings: These guidelines can help labs across the country to standardise their PGT services and improve clinical outcomes. Study Funding/Competing Interest(S): The consensus meeting and writing of the paper was supported by funds from CooperSurgical India.

Study Question: What are the good practices for the use of ADD-ON Treatments in IVF cycles in INDIA? What is Already Known: Add on treatments in IVF are procedures and technologies which are offered to patients in hope of improving the success rates. A lot of add on treatments exist; most of them have limited evidence and data for the Indian patient population is miniscule. These interventions may have limited effects, so it is imperative that any new technology that is offered is evaluated properly and has enough evidence to suggest that it is safe and effective. Study Design, Size, Duration: This is the report of a 2-day consensus meeting where two moderators were assigned to a group of experts to collate information on Add on treatments in IVF in INDIA. This meeting utilised surveys, available scientific evidence and personal laboratory experience into various presentations by experts on pre-decided specific topics. Participants/Materials, Setting, Methods: Expert professionals from ISAR representing clinical and embryology fields. Main Results and the Role of Chance: The report is divided in various components including the health of the Offspring, the various ADD ons available to an ART center, consensus points for each technology & qualifications and trainings for embryologists, the report and recommendations of the expert panel reflect the discussion on each of the topics and try to lay down good practice points for labs to follow. Limitations, Reasons for Caution: The recommendations are solely based on expert opinion. Future availability of data may warrant an update of the same. Wider Implications of the Findings: These guidelines can help labs across the country to standardise their ART services and improve clinical outcomes, it will also motivate clinics to collect data and report the use of Add ons to the national registry. Study Funding/Competing Interest(S): The consensus meeting and writing of the paper was supported by funds from CooperSurgical India.